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A Māori-centred inquiry into health governance : Māori directors on District Health Boards : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Philosophy in Management at Massey University, Te Papaioea/Palmerston North, Aotearoa/New Zealand

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Abstract

As is characteristic of colonised countries indigenous peoples experience phenomenal cultural and material loss culminating in marginalisation. Despite colonial devastation Māori, the indigenous peoples of Aotearoa/ New Zealand, move forward with ever increasing presence and voice in every institutional sector in this country in an attempt to reclaim and restore Māori wellbeing. While disparities in health continue to demonstrate colonial devastation, health is one such sector where increasing Māori empowerment is evident. The relatively recent legal provision for Māori representation at a District Health Board level offers direct, regional Māori governance input. However, as with other sectors, inevitable neo-colonial vestiges constrain Māori autonomy. Rapidly developing indigenous scholarship opens up previously unavailable paths for indigenous researchers with which to increasingly empower Māori. However, the opportunity to do this within management studies, particularly within the governance field, remains limited. Governance and health governance theory, firmly grounded in Western rationality, has yet to benefit from indigenous challenge. Postcolonial theorists articulate and contest Western dominance in management studies and offer emergent challenge to governance theory. In the desire to know more about director activity and efficacy, current governance theoretical debate in management studies calls for primary or first-order data where directors themselves reflect on their governance experiences.
The juxtaposition of legislative changes to health governance and provision, rapidly developing indigenous scholarship, and emergent postcolonial challenge within management studies have given rise to this research question –
What is the experience of Māori directors on District Health Boards?
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This study provides primary or first-order Māori-centric data on intra-board process. Māori research constructs guide the research process methodologically and analytically. Semi-structured interview data generating a thematic analysis reveals Māori not only experience the Western-hypothesised governance complexities and demands but also considerable additional complexity and demand. The assistance of a postcolonial lens brings into sharp focus the nature of these additional complexities and demands and attributes them to a deficit in Pākehā bicultural knowledge and accommodation. The neo-colonial hierarchal construction of Māori as the ‘Other’ evokes multiple dysfunctional mechanisms such as tokenism, stereotyping, institutional racism, political correctness, and evokes the ‘burden of representation’. Mechanisms such as these impede intra-board activity, representing significant governance process loss. In addition the lack of accommodation of Māori cultural governance aspirations also represent governance process loss. The articulation of dysfunctional colonial mechanisms that manifest at the DHB board table is a first step in a reconstruction of a different intra-board functioning. This, in conjunction with due regard to Māori cultural governance contributions and aspirations, suggests transformational possibility.